People's profile: People who sell sex

Healthwatch Lincolnshire was commissioned by the CQC to undertake engagement with people who sell sex.  We primarily engaged with this group via online and in-person surveys, follow-up semi-structured interviews, and interviews conducted by partnership organisations. The questioning framework covered access to primary care, mental health, cancer and dementia services, and awareness of CQC.  They spoke to 61 people rom a range of ages, members of the LGBTQ+ community and people who work in various areas of the sex industry, including: indoor independent works, escort agency works, online subscription workers and street sex workers. 

By far the biggest issue raised during this work was the judgement that people who sell sex often face when accessing health and care services. This included insensitive comments, a lack of understanding of their needs and circumstances, and assumptions that physical and mental health concerns are due to selling sex. As a result of this, many people shared that they do not disclose what they do to earn money when accessing services, especially GP and hospital services, due to fears of being judged or treated differently.

Professionals at sexual health clinics tended to be more understanding of the needs of people who sell sex and less judgmental. However, this again was not always the case and tended to depend on experiences of treating patients in, and knowledge of the industry.

Many of those who sell sex are very vulnerable and face multiple, intersecting stigmas, with a range of adverse health and non-health related outcomes. More than half of the respondents had experienced domestic abuse and more than 40% earned less than £18,000 a year. At least 70% had a long-term health condition and more than a quarter had a disability and/or were carers.

Many of those who sell sex are very vulnerable and face multiple, intersecting stigmas, with a range of adverse health and non-health related outcomes. More than half of the respondents had experienced domestic abuse and more than 40% earned less than £18,000 a year. At least 70% had a long-term health condition and more than a quarter had a disability and/or were carers.

73% (30) had heard of the CQC and when explained that the CQC “collects good and bad feedback about healthcare”, 76% (31) said they would share their thoughts about healthcare with the CQC. 

Overall, the majority did not feel that the needs of their community were understood and even more did not feel their needs were thought about when decisions about health services were made. Surveys, one-to-one interviews, and group discussions were all ways respondents would choose to get involved. While no single preferred way to get involved was identified, there appeared to be a preference for online and anonymous forms of engagement, as there was still some mistrust and concerns around being identified. It was also clear that engagement should be flexible in terms of time commitment and changes in circumstances.